Playing games in the office is one of those Silicon Valley stereotypes that might make your eyes roll when it crops up in another industry. Without a doubt, the Center for Health Care Innovation is Penn Medicine’s most Silicon Valley-esque enterprise, staffed with people who seemingly all have the word “Innovation” or “Design” in their job titles, sitting at bright tables surrounded by white boards, using the verb “iterate” with alarming frequency.
It’s easy to get tripped up on the vocabulary. The term “innovation” itself is so often used in health care and in other fields these days that it sounds shallow and empty. In some places, it’s just one more trendy piece of business jargon that makes people feel good about themselves for being hip to the times. As a person whose occupation is in words, and in the evidence-based realm of academic medicine and science, I aim to squash empty business jargon at every opportunity. So why have an “innovation issue” of Penn Medicine?
This issue exists because innovation is not a hollow term here. To see how, let’s go back to games.
The card game I recently found myself playing with the innovation center’s staff belies every stereotype. For starters, it was invented here. The “Accelerators in Health Care” game started with an idea from Executive Director David Asch, MD, MBA, and grew into a tangible object that has been professionally manufactured for sale and put into use in conferences and educational settings.
The game is more than a fun way to spend half an hour at work. It’s also a collection of insights you can hold in your hands. It codifies two key ingredients of creativity—analogies and constraints—into phases of game play. Players try to think of innovative solutions to a health care challenge by drawing on analogies presented in the hand of “Accelerator” cards they’ve drawn. The analogies come from successful businesses outside of health care, celebrities, or common tropes—like a Netflix card (your solution should provide a vast, searchable library of resources), a Guy Fieri card (your solution amplifies an experience to its extreme), or a Frankenstein card (your solution combines two or more things that are not usually connected). In the next round, players try to sabotage one another’s ideas with “Monkey Wrench” cards that represent constraints to progress, such as budget cuts.
You can see the results in the innovation center’s work, such as a streamlined model they developed to care for patients with high blood pressure. The “breakthrough” moment, according to Chief Innovation Officer Roy Rosin, was primary care physician Matt Rusk’s suggestion to design a hypertension clinic in the mold of Jiffy Lube, specialized to provide only the necessary services in a simplified setting—not sending patients to the equivalent of an auto mechanic when all they need is an oil change. The model involves only a few minutes with a doctor. Patients then interact via text messages with a nurse and have supervised titration of medications outside of the office to get to a desired blood pressure. The result has been a leap from 30 percent of patients having blood pressure under control within six months, to 100 percent, with a greater average reduction in pressure as well. And primary care physicians gained back an hour of time per each patient that they could spend addressing more complex needs.
Fresh ideas—or ideas from seemingly unrelated fields, freshly applied to health care—are only a first step of innovation, as Asch is careful to point out. Vital next steps include testing those ideas and understanding which ones work best for a given patient population. One feature story in this issue shows how the innovation center team walks the walk of that work.
Innovation doesn’t just happen through the efforts of one center at Penn, of course. This issue’s stories run the gamut from bioinformatics uses of artificial intelligence to a lifetime-spanning evolution of medical information technology, to a literal use of games—video game technology—to apply augmented reality in surgery.
The result, I hope, is an issue that is informative, instructive, and, yes, innovative. More than that, we’ve tried to play the Oprah Winfrey card, as described in the Accelerators game: “Generate delight by providing something joyfully unexpected, and beyond what is necessary.”
Read on, and have fun!